An Act to Improve Oral Health for All Massachusetts Residents focuses on providing care for underserved populations and reducing socioeconomic barriers to seeking dental care. This comprehensive approach to improving oral health would create a new class of midlevel providers called dental therapists, while enacting commonsense requirements to protect patient safety. It also calls for oral health education for community health workers, education and assistance for local and regional boards of health related to community water fluoridation, and information for parents on children’s oral health screenings.
Key provisions of the legislation include:
As a condition of licensure, dental therapists must:
- Obtain a bachelor’s and master’s degree
- Pass a comprehensive, competency-based clinical examination approved by the Commission on Dental Accreditation (CODA)
Dental therapists must work under the direct supervision of a licensed dentist for the first two years or 2,500 hours of practice, whichever is longer. After that time, dental therapists are authorized to perform under general supervision:
- All procedures and services within the scope of a public health dental hygienist
- All procedures and services listed in the CODA dental therapy standards
Advanced procedures—such as preparation and placement of direct restorations in primary and permanent teeth, preparation and placement of preformed crowns on primary teeth, and simple extractions of erupted primary teeth—must be performed under direct supervision. The supervising dentist can further limit the scope.
To ensure proper supervision, a supervising dentist is limited to having a collaborative management agreement with no more than three (3) dental therapists at the same time.
If practicing outside of a federally qualified health center, dental therapists must maintain a caseload of at least 50% of patients who receive coverage through MassHealth or are considered underserved.
Community Health Workers
As a condition for certification or renewal of certification, community health workers must receive education and or training in oral health.
Community Water Fluoridation
To increase awareness of the health benefits of fluoridated water in public drinking supplies, local and regional boards of health must be provided information, education, technical assistance, and seminars regarding water fluoridation as requested by municipalities and other local and regional governmental entities.
Children's Oral Health Screenings
Additionally, all public schools shall notify parents or legal guardians concerning the importance of oral health screenings, including information on programs and services to access affordable dental care.